1. Effect of PCSK9 inhibitors on pulse wave velocity and monocyte-to-HDL-cholesterol ratio in familial hypercholesterolemia subjects: results from a single-lipid-unit real-life setting.
- Author
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Scicali R, Di Pino A, Ferrara V, Rabuazzo AM, Purrello F, and Piro S
- Subjects
- Aged, Anticholesteremic Agents administration & dosage, Anticholesteremic Agents adverse effects, Blood Flow Velocity drug effects, Cholesterol, HDL blood, Cohort Studies, Drug Therapy, Combination, Ezetimibe administration & dosage, Ezetimibe adverse effects, Ezetimibe pharmacology, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Hyperlipoproteinemia Type II drug therapy, Italy, Leukocyte Count, Lipid Metabolism drug effects, Male, Middle Aged, Monocytes drug effects, Monocytes pathology, Prospective Studies, Pulse Wave Analysis, Anticholesteremic Agents pharmacology, Hyperlipoproteinemia Type II blood, Hyperlipoproteinemia Type II physiopathology, PCSK9 Inhibitors
- Abstract
Aims: Subjects with familial hypercholesterolemia (FH) are characterized by an increased amount of low-density lipoprotein cholesterol (LDL-C) that promotes a continuous inflammatory stimulus. Our aim was to evaluate the effect of PCSK9-i on inflammatory biomarkers, neutrophil-to-lymphocyte ratio, monocyte-to-high-density lipoprotein ratio (MHR), and on early atherosclerosis damage analyzed by pulse wave velocity (PWV) in a cohort of FH subjects., Methods: In this prospective observational study, we evaluated 56 FH subjects on high-intensity statins plus ezetimibe and with an off-target LDL-C. All subjects were placed on PCSK9-i therapy and obtained biochemical analysis as well as PWV evaluation at baseline and after six months of PCSK9-i therapy., Results: After six months of add-on PCSK9-i therapy, only 42.9% of FH subjects attained LDL-C targets. As expected, a significant reduction of LDL-C (- 49.61%, p < 0.001) was observed after PCSK9-i therapy. Neutrophil count (NC) and MHR were reduced by PCSK9-i (-13.82% and -10.47%, respectively, p value for both < 0.05) and PWV significantly decreased after PCSK9-i therapy (- 20.4%, p < 0.05). Finally, simple regression analyses showed that ∆ PWV was significantly associated with ∆ LDL-C (p < 0.01), ∆ NC and ∆ MHR (p value for both < 0.05)., Conclusions: In conclusion, PCSK9-i therapy significantly improved lipid and inflammatory profiles and PWV values in FH subjects; our results support the positive effect of PCSK9-i in clinical practice.
- Published
- 2021
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